Healthcare Innovations

If Obama's Current Plans are Executed

It seems totally impossible that the Obama administration will be able to implement their election-campaign plans for health care, but I agree that the economic crisis could help. The insurance industry as it exists in no friend to the economy.

The Health Care Blog: Moody's predicts winners & losers in Obama health reform, 2008-Nov-18, by Jane Sarasohn-Kahn:

Promoting access to health care in the U.S. could be a positive for hospitals and medical device manufacturers, whose sheer volumes of patients would increase and uncompensated care and bad debt be reduced. On the downside, though, addressing cost containment through reducing reimbursement would be a negative for hospital finances. The net of lower payments coupled with higher volumes remains to be seen. Still, Moody's says that the overall impact on hospitals, providers and clinical services will be generally credit positive.

A loser could be health insurers. While more enrollees would be covered, the government would regulate these markets more tightly and cut payments to insurers to fund the new health plan. If insurers negotiate tougher reimbursements in hospital agreements, this, too, would negatively impact hospitals' top-lines. For health insurers and managed care, Moody expects the sector to score generally credit negative.

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Improving Hospitals

Hospitals handling failure out in the open.

The Health Care Blog: Transparency Works!, 2008-Nov-14, by Paul Levy

I just saw clear evidence of the importance of transparency with regard to the reporting of important adverse events and medical errors. Bear with me through the details, but I will not keep you in suspense regarding the conclusion: The wide disclosure of a "never" event in a blame-free manner resulted in an intensity of focus and communal effort to solve an important systemic problem, resulting in redesign of clinical procedures, buy-in from hundreds of relevant staff people, and an audit system that will monitor the effectiveness of the new approach and leave open the possibility for ongoing improvement.

If you ever needed a clear example of the power of transparency, here it is.

Looking at Your Phone to See How Healthy You Are

I like the idea of checking my blood pressure with my phone, but I can easily see some people getting obsessive about it.

The Institute For The Future: Reinventing Health Care in a Mobile World, 2008-Sep-3, by Jeff Burgan

The mobile phone is becoming an important platform for managing health, facilitating transparency in market transactions, and accessing health information in more contexts and settings across the global health economy. Soon the mobile phone will become not only a tool for accessing market information at the point of purchase, but also an important tool for managing our health identities and sustaining good health behaviors. Already, downloadable applications are transforming mobile phones into tools for weight loss, glucose monitoring, or adherence to medical treatment. 

Streamling Healthcare

This idea appeals to me because it could make health care simpler and more straightforward for the consumer. Hard to believe anybody at IBM could make things simpler, though.

The Health Care Blog: The Health Care Blog, 2008-Aug-17, by Dr. Richard Reece

Major corporate buyers, led by IBM, which spends $1.7 billion on health care, have created an activist organization, The Patient-Centered Primary Care Collaborative. Paul Grundy, MD, MPH, IBM’s Director of Health Transformation, chairs the Collaborative. It is based partly on IBM’s experience in Denmark, where it owns a company, and where patient satisfaction with care is 97% versus 50% in the U.S. Grundy believes every citizen should have a personal physician, and every physician should be rewarded for offering same day access, managing a patient panel, and be compensated for telephone and email consultations.

If Only IT Could Save Health Care

In the Wall Street Journal's special section on Business Insight, Amar Gupta, University of Arizona professor of entrepreneurship and IT, weighs in how information technology will change health care in the coming years. It sounds wonderful but I can't help but thinking that health care bureaucracy will slow all these down.

Wall Street Journal: Prescription for Change, 2008-Oct-20, by Amar Gupta

What follows is a look at four major ways in which IT will revolutionize health care:

• more offshore services,
• integration of health-information systems,
• drug-safety monitoring on a global scale, and
• more high-quality information to doctors and patients.

Health Business Blog » Blog Archive » Turning primary care on its head

What would be the implications in the US of shifting power away from the AMA’s Relative Value Scale Update Committee (RUC), which favors proceduralists over primary care? What if the American Academy of Family Physicians were placed in charge of this function and turned things upside down?

Health Business Blog » Blog Archive » Turning primary care on its head 2008-Nov-18, by David Williams

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Specialized Network Platform

Excellent adaption of networking platform to micro-local health care.

Lotsa Helping Hands: Lotsa Helping Hands can help you or someone you love to easily organize family members, friends, and others during times of medical crisis, family caregiver exhaustion, or when caring for an aging loved one. Or just coordinate a group of volunteers for your neighborhood, school, religious institution, or Scout Troop. Whether coordinating volunteers for meals, rides, or visits, or just sharing photos, medical status updates, well wishes, or vital medical, legal, or financial information with select members of the community, a Lotsa Helping Hands private web community can help.

Looking Over Researchers' Shoulders

The Michael J Fox Foundation is building new models of collaboration between funding organizations and researchers.

BIF Speak: Debi Brooks: Medical Research Change Agent. 2008-Jun-27, by Chris Flanagan

The foundation uses an accelerated grant system to make award decisions within two months of receiving research proposals. The duration of a typical award is two years, and MJFF money is significant -- most awards are in the hundreds of thousands of dollars, and some programs offer multi-million-dollar funding.

But arguably even more importantly than speed and award size, scientists are held accountable for the money MJFF invests in their research. Every award is milestone-based and every awardee is required to meet with the foundation at the midway point to report on progress. In the Foundation's early days scientists balked at this requirement, but they soon began to see the benefit of sharing their work with peers and getting constructive feedback while their work was in progress.

Patient-Centered Medical Records

Being able to access our medical records is not the same as being able to use our medical records.

Linux Journal: The Patient as the Platform, 2008-Jun-24, by Doc Searls

I believe that having a data store for health records is a necessary but insufficient condition for the true independence and control required for each of us to be the point of integration for the health care we get, and the point of origination for controlling that care — for getting second and third opinions, for summoning data across bureaucratic boundaries, for actually relating to the systems that serve us, rather than serving as dependent variables within them.

For patients to become platforms, we need more tools and capabilities that are native to the patient. All of us need to be able to walk around the world with the ability to jack into any health care system and drive it. How? I don't know yet. I'm still new to this. But I do know that these are capabilities we need to add to ourselves, as independent drivers of health care services. And that these must be based on free and open standards and code.

The new health care infrastructure must be built on independent and autonomous patients, not on systems that surround and subordinate patients. Once it is, the systems will be vastly improved, and far more profitable for all.

We cannot fix health care only at the institutional level. No company and no government agency can fix health care, any more than any company or government could fix networking or computing. Those had to be fixed by hackers building solutions for everybody and not just themselves. (Even if they were just "scratching their own itch".) Today the Internet, Linux, and countless free and open source code bases are core infrastructural systems on which civilization itself relies. The amount of business this vast and growing infrastructure supports so far exceeds the amount it undermines and obsoletes that it's silly to even bother doing the math — if it could be done in any case. One might as well argue against the Big Bang.

Real Innovation: Pushing an Idea into Reality

I first heard about the Eden Alternative when Fast Company magazine did a profile of Bill Thomas. Too bad you can't see the fabulous photos online (Fast Company didn't purchase online rights to the photos). Those images of elderly people people living with their caregivers in a garden-like environment took hold in many people's minds. The original concept has taken a big journey and is now the basis for numerous experiments in healthcare.

WSJ.com: Rising Challenger Takes On Elder-Care System. 2008-Jun-24, by Lucette Lagnado

Robert Jenkens, who is spearheading the Green House project at NCB Capital for Robert Wood Johnson, says that some not-for-profits and at least one for-profit believe the model to be financially viable. St. John's Lutheran Ministries in Billings, Mont., operates both a nursing home and some Green Houses. In an internal review, officials found that it cost $192 a day to care for a resident in the traditional nursing home versus $150 a day in their Green Houses.

While building costs were high, Vice President David Trost says the Green House model also has cost savings. "We no longer have to take a resident 200 feet to the dining room -- we only have to take them 20 feet, and that is significant," he says.

Robert Wood Johnson executives say financial sustainability is a question they're scrutinizing intently. Based on this "first round" of Green Houses, they believe that it is financially doable, but they are rigorously testing the model and developing software that should help providers determine whether they can handle Green Houses financially.